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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

Row over 'pay cartel' reaches parliament

MPs are due to debate the threat of regional pay to the NHS and the actions of the South West “pay cartel” this week, in a move designed to spark action from the government.

As part of a Labour Party debate in parliament on Wednesday, politicians will vote on a motion highlighting the growing threats to Agenda for Change. It will also call for the South West Pay, Terms and Conditions Consortium of 20 trusts to be stopped from leaving the national pay framework.

The debate comes as more trusts have threatened to break away from the national pay structure. North Tees and Hartlepool NHS Foundation Trust is planning to sack 5,452 staff on 31 March and re-employ them on reduced terms and conditions.

However, some trusts have also stated their commitment to the national deal, meaning the NHS is facing growing fragmentation over terms and conditions.

Shadow health secretary Andy Burnham told Nursing Times that next week’s Commons’ debate was aimed at “flushing” out the government’s position on NHS pay. “There is growing confusion about government policy on regional pay and we need to have some definite answers,” he said.

“National pay is a key plank of the NHS, it is the glue that holds the whole system together and the government has failed to step in and make its position clear,” he added.

Mr Burnham said the South West Consortium had “emboldened other trusts around the country”, which were now starting to adopt a similar approach. He warned that regional pay would cost more and disproportionately affect deprived areas.

Labour would seek “common cause” with Liberal Democrat MPs in the debate and vote, he said.

The former health secretary denied the threat to national pay was a direct result of freedoms given to foundation trusts by the previous Labour government.

Mr Burnham said: “There were freedoms but they were for use at the margins for individual circumstances, not the wholesale opt-out of Agenda for Change.

“If this is a loophole that trusts are using we will seek to close it [if Labour is returned to power at the next election],” he said.

He said he also planned to review legislation surrounding foundation trusts in the light of the Francis Report into the scandal at Mid Staffordshire Foundation Trust, which is expected early next year.

Meanwhile, unions are consulting on what action to take to oppose regional pay, according to Christina McAnea, chair of the Staffside Council and head of health at Unison.

She told a nursing seminar in Birmingham last week that she calling on members to suggest forms of protest short of striking, because she was aware many healthcare workers were “nervous” or “reluctant” about taking industrial action because they feared the impact it would have on patient care.

"She told a nursing seminar in Birmingham last week that she calling on members to suggest forms of protest short of striking, because she was aware many healthcare workers were “nervous” or “reluctant” about taking industrial action because they feared the impact it would have on patient care."

This is exactly the "weakness" which the Trust is relying on!

Being "nervous" and "reluctant" in the face of naked aggression from the Trust is a stance which will ensure the Trust wins !

If all else fails industrial action must be taken ! Seeking soft options to "protect patients" will not work !

All the Staff employed by North Tees and Hartlepool NHS Foundation Trust are now are aware of exactly how well they are regarded by the Trust.

The Trust wants to reduce staff pay and remove other terms and conditions of service. The Trust has to be made aware that such behaviour is unacceptable. An Extremely robust stance must be taken by the staff.

Whatever problems the Trust has does not justify ill treating valuable staff!

If patients "suffer" it is the fault of the Trust Chairman. Board Member, and Executives ! Do not forget these people dont intend to forgo their obscene salaries or their Bonuses !

it's all a bit rich isn't it, asking for help from the government about pay cartels when they are pulling all the strings anyway, making nurses redundant and the all the rest of the shut down of the NHS for frontline workers.

All they will be left with ultimately is a load of useless managers who mostly have been promoted beyond their competence level, who will then not be fit for purpose as no private sector business in their right mind would want to employ them as managers anyway.

To say that nurses are too scared to take action because of concerns about patients welfare is a bit rich too as patients are already suffering due to cutbacks etc., So if we've got to do something 'horrible' let's do it quickly rather than drag it out over a longer period of time where patients are suffering anyway and for longer. No one should have to die as a consequence of industrial action if there is an organised strategy, but it seems within nursing there has never been any organisation as we have been leaping through hoops and kept in a total state of confusion with ongoing and unrelenting changes year in year out.

Time to take a stand for the everyone, ourselves and patients wellbeing and stop having a 'pity party' about it all.

Time to take back some control rather than waiting on the whims of a heartless government who only real concern is making a fast buck at the cost of anyone that might make their life a bit more difficult and stop all the martyrdom attitude that we can't do anything because we care about the patients. Really? Where's that got any of us, out of a job, used as doormats with less staff to care for the patients.

Come on nurses, time to take a stand. We are a mighty force to be reckoned with if we choose to stand up for ourselves but too afraid to use it. Think that makes us victims when we could be victors.

If those 5000+ staff, en masse, stated that they will refuse to sign amended contracts, the Trust woul dhave no option to buckle. The threat of all their front line staff not turning in to work following termination of their contracts would mean they would have no option to reconsider. They could not ensure that volume of agency cover for these staff (or afford it), and they could not risk calling the bluff. Thre is no need for actual industrial action to take place, just the consolidated threat (with real intent).

Anon 8.51 and 5.19
No, the staff should all take redundancy and REFUSE to return to work.
I had Peter Carter in my trust the other week, he wont do anything about this, he'd rather have an internicine war with Unison then galvanise the membership WHO PAY HIS WAGES.
Demand from your RCN/ Unison steward action over this. We either stand united or not at all.

I never thought I could go on industrial action but now I feel very strongly about this, I vote for this as these people don't care about me, a nurse with aches all over after a days work, I work so hard and have so little to spend and they still feel they can damage me more untill I am brain dead. I am not the reason this country is in a mess.
I pray those 5000+ staff stand united for themselves and the rest of us.
They will be in my prayers.

The government should never have allowed foundation trusts to opt out of agenda for change in the first instance, and no NHS trust should be allowed to now. If they had to comply full stop,without any chance of opting out, groups like the south west cartel would not have had a chance, and would not have formed because they wouldn't have been allowed to.

if you are made redundant and have your contract terminated then don't go into work as you have no job. if your employer wants to re-imploy you then let them adverise the posts and interview 5,000 staff, take up references, enchanced CRB checks etc.

Action needs to be taken but lets be clever about what action is taken. Lets all start working to rule, if as I do you work 9 to 5 with half an hour for lunch don't start your shift until 9 don't work past 5 and make sure you take your lunch break. Not as I do and I'm sure most on here do, get in a few minutes early and stay over a few minutes / hours * delete as applicable * as for lunch breaks what are they

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